Kristin Rowland Derrick, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4208 Issued in SC

Practice address

1208 Springdale Dr
Clinton, SC 29325-7225

Phone

(864) 833-5400

Fax

(864) 833-5417

NPI assigned

Dec 12, 2006

Last updated

Mar 14, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Miss Kristin Adair Rowland Former name

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clinton Dental Care LLC

  • General Practice Dentistry
  • Clinton, SC
  • NPI 1063614469
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520985600000",
    "number": "1114088556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 837",
            "city": "CLINTON",
            "state": "SC",
            "postal_code": "293250837",
            "telephone_number": "864-833-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 SPRINGDALE DR",
            "city": "CLINTON",
            "state": "SC",
            "postal_code": "293257225",
            "telephone_number": "864-833-5400",
            "fax_number": "864-833-5417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERRICK",
        "first_name": "KRISTIN",
        "middle_name": "ROWLAND",
        "name_prefix": "Mrs.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2018-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "4208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "ROWLAND",
            "middle_name": "ADAIR",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel P. Hartley, DMD, PA
• Whitney Davidson, LISW-CP
• Rebecca Ann Day, RD, LD
• Debra a Stone (Rewarding Services Debra a Stone)
• Adrianna Fox Deise, APRN
• Justin Dillon, LPC
• Kristen Marie Dodge
• Heidi Leigh Dressler
• Jasmine Drummond
• Veronica Denise Duckett, LPN

• General Practice Dentistry in Clinton, SC
• Providers in Clinton, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.